DEA Will Allow Consumers to Return Unused Prescription Drugs

The federal government is finally addressing this country’s serious abuse of prescription drugs with more resources than just those that regulate health care. The Drug Enforcement Administration (DEA) has agreed to allow consumers to return unused prescription drugs to pharmacies to improve the chances that they won’t be used except for what they were intended for.

As reported last week in the New York Times, of most concern are drugs classified as controlled substances, such as opioids (painkillers) including OxyContin, stimulants including Adderall and depressants including Ativan. The DEA wants to reduce unneeded medicines that are ripe for abuse by the patients’ family, or stolen for resale on the street.

As we’ve blogged, injuries and deaths from dangerous drugs, especially opioids, have risen sharply in recent years, and as The Times noted, more than 7 in 10 teenagers say it is easy to get prescription drugs from their parents’ medicine cabinets.

The new regulation permits patients and their relatives to deliver or mail unused prescription meds to authorized collection centers in packaging that will be available at pharmacies, senior centers, libraries and other public locations. It’s supposed to go into effect next month.

Until now, it was illegal to return drugs – the Controlled Substances Act permitted only patients to dispose of the drugs themselves, or turn them into law enforcement agencies. Twice a year, the DEA sponsored a national “take back” event for people to return drugs anonymously to local police departments, sort of like the gun buy-back programs some communities sponsor, and in the last four years, according to The Times, 4.1 million pounds of prescription medications have been turned in.

But there’s plenty more where they came from: About 3.9 billion prescriptions were filled at pharmacies last year, according to the Kaiser Family Foundation.

The semi-annual events removed only “an infinitesimal fraction of the reservoir of unused drugs that are out there,” Dr. Nathaniel Katz told The Times. He teaches at the Tufts University School of Medicine in Boston and studies opioid abuse. “It’s like trying to eliminate malaria in Africa by killing a dozen mosquitoes.”

But Katz hopes the new effort will have a bigger effect. Having drop-off receptacles for controlled substances in pharmacies offers unlimited disposal opportunities.

Of course, people can always flush medicine down the toilet, or dispose of it in the trash, but those habits are discouraged because of environmental concerns.

Some observers warn that because the program is voluntary there’s no guarantee that a sufficient number of venues will establish take-back programs or set up collection receptacles to make a difference, and that other obstacles might arise.

Police departments, for example, often incinerate the illicit drugs they seize, but a local pharmacy might not be able to do that. So their collections would arrive solely by mail, which is probably asking a lot of consumers these days. Also, who pays for the disposal – communities, pharmacies, insurance companies, patients or pharmaceutical companies – isn’t addressed in the DEA’s new rule.

We believe that because the pharmaceutical companies make the profit on these dangerous products they also should bear the costs of removing them in order to minimize their harm when used inappropriately. Is anyone surprised that they’ve objected to this idea? (See our blog, “Drug Companies Oppose Requirements to Take Back Unused Medicine.”)

MedReturn manufactures steel boxes used by police stations in 49 states to collect prescription drugs. Some people worry about their security, because if they “are available to the public, they have to be under law enforcement eyes, because they are gold at the end of the rainbow for someone with an opioid addiction,” Gary Tennis, secretary of the Department of Drug and Alcohol Programs in Pennsylvania, told The Times. His department has 200 MedReturn boxes and plans to install 100 more.

And last year, the American Pharmacists Association told the DEA it was concerned that pharmacies could be held legally liable if a secure drug drop-off receptacle was broken into and its contents stolen. It cautioned that in such uncharted legal waters, pharmacies might be reluctant to participate in a disposal program.

But the biggest obstacle to getting people into the habit of disposing of their unused and unneeded drugs is the understanding that it’s irresponsible to do otherwise.

Still, the new DEA regulation, Dr. G. Caleb Alexander told The Times, “is big news and long overdue.” He’s co-director of the Center for Drug Safety and Effectiveness at Johns Hopkins Bloomberg School of Public Health. “It’s baffling that it’s so easy to get a prescription for opioids and yet so difficult to dispose of these drugs safely.”

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